| NPI | 1174976963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI KRESS CEO 651-699-0206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2023-04-27 |